The Drum Beat 130: Critical Communication Perspectives - HIV/AIDS

HIV/AIDS is proving a very difficult, almost intractable issue. What should be the preferred HIV/AIDS communication strategy? 8 voices from different perspectives, experiences and roles in this epidemic follow. These contributions were made to the recent VIII International Communication for Development Roundtable - Excerpts follow. 

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1. Dorothy Onyango - Women Fighting AIDS in Africa
"Communication [of] HIV/AIDS messages has been one of the corner stones of prevention strategies in the past two decades. The general assumption has been that general knowledge of HIV/AIDS information will lead to behavior change. For this reason, IEC has been promoted as a simple solution to a difficult problem. This assumption has led to unrealistic expectations about the power of communication as a critical means to behavior change...why has the information provided not translated into the expected behavior? The answer is simply in the fact that the messages that people are hearing are not addressing their real needs. The majority of the people in Africa are people with very little resources and most of these people are first and foremost concerned about their basic needs, food, clothing, etc. If I do not have food to eat or a shelter, tell me in terms of priority where HIV will fall? My first need that I must satisfy is the basic essentials to help me survive after which I can maybe assimilate the prevention messages...."

Click here for Dorothy's full analysis and recommendations.
Contact: Dorothy Onyango wofak@iconnect.co.ke

2. Amy Bank - Puntos de Encuentro, Nicaragua
"To keep the [HIV/AIDS] time bomb from going off, the main challenge for us communicators in Nicaragua - in terms of prevention - is to raise the perception of risk in order to promote safer sexual practices, thereby lowering actual risk. If people don't perceive risk, it's possibly because so many other risks are so much closer to the surface: war, informal armed conflict, natural disasters like Hurricane Mitch, getting assaulted in the street, get in a car or bus accident, die from hemmoragic dengue or a botched abortion or diarrhea. In spite of such widespread poverty, the possibility of dying of hunger is a new clear and present danger. And at the moment, teen suicide is more of an epidemic than AIDS."

Click here for Amy's analysis of the HIV/AIDS context and communication challenges in Nicaragua and suggested strategies for effective action.
Contact: Amy Bank amy.bank@puntos.org.ni

3. Jennifer Sibanda - Federation of African Media Women
"Challenges for communication approach/Lessons learnt: Reporting positive aspects of the epidemic - reports should not all be gloom and doom - how are people living positively with the disease (both infected and affected population); How to make HIV/AIDS front page news without being sensational; Gender balanced reporting; Local dramas - too much violence and unfaithful relationships; Defining who are our role models; Information strategies that go beyond women to also include men - women have tended to organise themselves more than men and find that they are brought some steps backwards by men."

Click here for Jennifer's complete notes on Challenges/Lessons Learned and Successes.

4. Sylvie Cohen - UNFPA

Good [HIV/AIDS] advocacy process indicators needs:

• Beyond policy change: policy implementation for access to reproductive health services, economic empowerment; and
• Beyond consensus building: community empowerment to change harmful norms such as GBV, double standards for women and young people sexuality, and stigmatization of PLWAs
• Measuring the advocacy skills of civil society organizations
• Creating positive cultural milieu such as supportive networks for young people
• Partnering with men as policy-makers, community leaders, sexual partners and RH clients.
• Acknowledging conflict of interests [men accepting to release power and benefits; negative attitudes of providers; property rights; resistance to the language of rights]

Click here for Sylvie's analysis of challenges.
Contact: Sylvie Cohen cohen@unfpa.org

5. Winnie Ssanyu-Sseruma - African HIV Policy Network
"I feel a need to express my frustration about the kinds of questions we are still asking ourselves, 20 years into the HIV epidemic! Why are there more people infected with HIV around the world more than ever before? What is going wrong? Why is prejudice and stigma such a big problem? What is wrong with the messages being communicated to people about HIV? How come most people living with HIV do not have access to care and treatment? Why are resources still hard to come by to help solve a problem that the whole world desperately needs answers to?...Some of these responses emphasize the importance of the role of HIV positive people in the fight against AIDS. People living with HIV give a human face to the virus instead of theorizing about it. People do not seem to relate to statistics any longer, but can relate to others. However, HIV positive people need to be empowered with skills and get paid for the work they do."

Click here for Winnie's analysis and ideas.
Contact: Winnie Ssanyu-Sseruma winnie.ss@ukonline.co.uk

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6. Jose Rimon - Johns Hopkins University

Theory Driven Behavior Change Communication - Ideation

• Need to Identify/influence ideational factors related to desired behaviors - eg Abstinence; Being faithful to one partner; Consistent condom use; Delaying sexual debut; Seeking treatment for STIs; Seeking VCT; Preventing MTCT.
• Social legitimization: improving social environment; Breaking the silence; Improving policy environment/strengthening political will; Overcoming stigma; Agenda priority setting; Increasing public understanding of HIV impact.
• Social network: Stimulating couple & community discussions; Influencing community norms; Developing community capacities.
• Social learning/modeling: Modeling individual and collective self-efficacy; Modeling health provider behaviors; Scaling up entertainment education programming.

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Click here for more on Jose's conceptual framework.
Contact: Jose Rimon jrimon@jhuccp.org

7. Aulora Stally - SAfAIDS
Advocacy Communication - requirements include: "Focus on evidence-based stories with more investigative journalism using a variety of sources, less sensationalist coverage, headlines, reinforcing negative stereotypes...Promote open dialogue for plurality of voices - men, women, children, orphans and promote real life experiences, cover issues such as abortion, child welfare, access to condoms for young people and sexuality...Develop a network of journalists and eminent persons to contribute to shaping the public perception of HIV/AIDS...Journalists should move beyond health reporting and view HIV/AIDS as a development issue with wide socio-economic implications that reaches far beyond the health sector...Include stakeholders and policy makers in the communication process to share and develop thinking together..."

Click here for Aulora's full comments.
Contact: Aulora Stally astally@zol.co.zw

8. Denise Gray-Felder - The Rockefeller Foundation [and Chair of The Communication Initiative Partners Group]
"Challenges, priorities, lessons learned: Communicating in ways and using methods that are natural/comfortable for the people, not imposing new - or foreign - ones at the start; Suspending all judgments - leaving your values and opinions at home; income generating activities; Don’t avoid AVOIDANCE - Avoidance is communication as well; Listen, respond and act - to community generated ideas, even those you think will not work; Focus on reducing donor dependency .. in all disciplines, including communication...HIV is a disease of poverty - we were naïve to think we could enter a community with a HIV communication program and not address their life needs - to have income...The role of men - can’t just focus on empowering women, young women. We have to change the paradigm before boys reach their sexual maturity."

Contact: Denise Gray-Felder denise@communicationforsocialchange.org

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